Does Breastfeeding Protect Against Substantiated Child Abuse and Neglect? A 15-Year Cohort Study

Date

2009

Journal Title

Journal ISSN

Volume Title

Publisher

Pediatrics

Abstract

Objectives: Child maltreatment is associated with multiple adverse developmental outcomes in children. Surprisingly, the most frequently reported perpetrator is the biological mother. Understanding early relationship factors that may help prevent maltreatment is of utmost importance. We explored whether breastfeeding may protect against maternally-perpetrated child maltreatment. Methods: 7223 Australian mother-infant pairs were followed prospectively over 15 years. In 6621 cases (91.7%), the duration of breastfeeding was analyzed with respect to child maltreatment (including neglect, physical abuse and emotional abuse), based on substantiated child protection agency reports. Multinomial logistic regression was used to compare no maltreatment with non-maternal and maternally-perpetrated maltreatment, and to adjust for confounding in 5890 cases with complete data (81.5%). Potential confounders included sociodemographic factors, pregnancy wantedness, substance abuse during pregnancy, postpartum employment, attitudes regarding infant caregiving, and symptoms of anxiety or depression. Results: Of 512 children with substantiated maltreatment reports, over 60% experienced at least one episode of maternally-perpetrated abuse or neglect (4.3% of cohort). The odds ratio (OR) for maternal maltreatment increased as breastfeeding duration decreased, with the odds of maternal maltreatment in non-breastfed children 4.8 times the odds for children breastfed 4 or more months (95% Confidence Interval [CI] 3.3−6.9). After adjusting for confounding, the odds for non-breastfed infants remained 2.6 times higher (95% CI 1.7−3.9), with no association seen between breastfeeding and non-maternal maltreatment. Maternal neglect was the only maltreatment subtype independently associated with breastfeeding duration (adjusted OR 3.8, 95% CI 2.1−7.0). Conclusion: Among other factors, breastfeeding may also help to protect against maternally-perpetrated child maltreatment, particularly child neglect. (Author Abstract)

Description

Keywords

breastfeeding, child abuse, neglect, mother-child relations, oxytocin, attachment, research, International Resources, Australia

Citation

Strathearn, L., Mamun, A. A., Najman, J. M., & O'Callaghan, M. J. (2009). Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatrics, 123(2), 483-493.

DOI